Hospital Notification for Chimeric Antigen Receptor T-cell (CAR-T) Therapies
Until further notice, please be advised that the Benefit Funds require pre-authorization for CAR-T immunotherapy (including Kymriah, Yescarta and other FDA-approved CAR-T Therapies) and/or related services, including outpatient or inpatient evaluation and the CAR-T outpatient or inpatient episode. These services may only be provided by certified treatment centers. Hospitals should contact CareAllies at (800) 227-9360 to obtain prior authorization.
If you have any questions about this notice, please the Prior Authorization Department at (646) 473-7446.
Hospital and Outpatient Services
You must get prior authorization from the Fund for certain surgical procedures, prescriptions, equipment requests and hospital services. Refer to our Provider Quick Reference Sheets or choose any of the links below to see if you need to apply for prior authorization.
Questions? Email us at Providers@1199Funds.org. or call our Provider Services Representatives at (646) 473-7160.
Services Requiring Prior Authorization
- Chiropractic Services
- Home Care, Certain Outpatient, DME and Rx
- Hospital Services
- Medical Oncology Services
- Molecular and Genomic Laboratory Services
- Outpatient Services and/or Ambulatory Surgical Procedures
- Prescription Program
- Radiation Therapy
- Radiology Imaging/Nuclear Cardiology Services
To request prior authorization for one of these services, use our Forms for Providers resources.